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Pech O, Günter E, Dusemund F, Origer J, Lorenz D, Ell C. Accuracy of endoscopic ultrasound in preoperative staging of esophageal cancer: results from a referral center for early esophageal cancer. Endoscopy 2010; 42:456-61. [PMID: 20306385 DOI: 10.1055/s-0029-1244022] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND STUDY AIM Endoscopic ultrasound (EUS) has been regarded as the most accurate staging tool in esophageal cancer. Staging results have a strong impact on the decision as to whether a patient should undergo endoscopic treatment, surgery alone, or neoadjuvant therapy. This retrospective study was conducted to analyze the accuracy of esophageal cancer staging using EUS. METHODS All patients who received EUS for staging of esophageal cancer before esophagectomy from February 2003 to December 2007 at a high volume academic tertiary care center were included. RESULTS 179 consecutive patients (mean age 64.4 +/- 9.5 years; 142 men) underwent esophageal resection for Barrett's adenocarcinoma (n = 134) and squamous cell cancer (n = 45). Postoperatively, 99 patients were staged as having T1 cancers (55 %), 30 patients T2 (17%), 46 patients T3 (26%), and four patients T4 (2%). The sensitivity and specificity of EUS relative to the T stage were 82% and 91%, respectively, for T1; 43% and 85% for T2; and 83% and 86% for T3. The overall accuracy for EUS in identifying the correct T stage was 74% (95%CI 66-80). Positive lymph nodes were diagnosed histologically in 68 patients (38%). The sensitivity, specificity and accuracy of EUS for the diagnosis of N1 were 71%, 74% and 73% (95%CI 65-79), respectively. CONCLUSIONS The diagnostic accuracy of EUS in patients with esophageal cancer is still unsatisfactory. T2 cancers in particular are frequently overstaged, with a significant effect on the subsequent treatment strategy.
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Adamczyk Z, Belouschek P, Lorenz D. Electrostatic Interactions of Bodies Bearing Thin Double-Layers III. Dissimilar Double-Layers. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bbpc.19910950505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Thier S, Lorenz D, Nothnagel M, Stevanin G, Dürr A, Nebel A, Schreiber S, Kuhlenbäumer G, Deuschl G, Klebe S. LINGO1 polymorphisms are associated with essential tremor in Europeans. Mov Disord 2010; 25:717-23. [DOI: 10.1002/mds.22887] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Simón-Sánchez J, Schulte C, Bras JM, Sharma M, Gibbs JR, Berg D, Paisan-Ruiz C, Lichtner P, Scholz SW, Hernandez DG, Krüger R, Federoff M, Klein C, Goate A, Perlmutter J, Bonin M, Nalls MA, Illig T, Gieger C, Houlden H, Steffens M, Okun MS, Racette BA, Cookson MR, Foote KD, Fernandez HH, Traynor BJ, Schreiber S, Arepalli S, Zonozi R, Gwinn K, van der Brug M, Lopez G, Chanock SJ, Schatzkin A, Park Y, Hollenbeck A, Gao J, Huang X, Wood NW, Lorenz D, Deuschl G, Chen H, Riess O, Hardy JA, Singleton AB, Gasser T. Genome-wide association study reveals genetic risk underlying Parkinson's disease. Nat Genet 2009; 41:1308-12. [PMID: 19915575 PMCID: PMC2787725 DOI: 10.1038/ng.487] [Citation(s) in RCA: 1457] [Impact Index Per Article: 97.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 10/21/2009] [Indexed: 01/13/2023]
Abstract
We performed a genome-wide association study (GWAS) in 1,713 Caucasian patients with Parkinson’s disease (PD) and 3,978 controls. After replication in 3,361 cases and 4,573 controls, two strong association signals were observed: in the α-synuclein gene(SNCA) (rs2736990, OR=1.23, p=2.24×10−16) and at the MAPT locus (rs393152, OR=0.77, p=1.95×10−16). We exchanged data with colleagues performing a GWAS in Asian PD cases. Association at SNCA was replicated in the Asian GWAS1, confirming this as a major risk locus across populations. We were able to replicate the effect of a novel locus detected in the Asian cohort (PARK16, rs823128, OR=0.66, p=7.29×10−8) and provide evidence supporting the role of common variability around LRRK2 in modulating risk for PD (rs1491923, OR=1.14, p=1.55×10−5). These data demonstrate an unequivocal role for common genetic variability in the etiology of typical PD and suggest population specific genetic heterogeneity in this disease.
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Klebe S, Thier S, Lorenz D, Christensen K, Kuhlenbäumer G, Nebel A, Schreiber S, Deuschl G. GABA(A) Rezeptoren als Suszeptibilitätsfaktoren beim essentiellen Tremor. AKTUELLE NEUROLOGIE 2009. [DOI: 10.1055/s-0029-1238863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lorenz D, Papengut F, Frederiksen H, Kopper F, Klebe S, Christensen K, Schreiber S, Deuschl G. Evaluation of a screening instrument for essential tremor. Mov Disord 2008; 23:1006-1012. [PMID: 18381648 DOI: 10.1002/mds.22010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
To evaluate a screening instrument for essential tremor (ET) consisting of a seven-item questionnaire and a spiral drawing. A total of 2,448 Danish twins aged 70 years or more and a second sample aged 60 years or more (n = 1,684) from a population-based northern German cross-sectional study (PopGen ET) were screened for ET. Inclusion criteria were a previous diagnosis of ET, a positive answer to two or more questions of the questionnaire or a spiral rating >4 (range of scale 0-9). Three hundred thirteen of 380 positively screened and 321 negatively screened subjects were clinically examined. Definite or probable ET was diagnosed in 104 patients, possible in 86 and other tremors in 98 patients. The sensitivity of the screening instrument was 70.5%, the positive predictive value was 64.9%, the specificity was 68.2%, and the negative predictive value was 73.5%. Tremor severity correlated significantly with higher spiral scores and more positive items. More patients were identified by spiral drawing in all tremor groups. The interrater and intrarater reliability for spirals ranged from 0.7 to 0.8 using intraclass coefficient. A cluster analysis revealed that the questionnaire can be reduced to three items, about uncontrollable tremor in any body part, tremor while drinking or pouring and other family members with tremor, without loosing efficacy. We present an easy to use and reliable screening instrument that is effective to identify patients with ET but not able to exclude patients with other tremor forms.
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Harter P, Grabowski J, Buhrmann C, Lorenz D, Kaub C, Hils R, Kommoss S, Traut A, du Bois A. Effekt der Zweitoperation bei invasivem Ovarialkarzinom in einem gynäkologisch-onkologischen Zentrum. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1079241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Richter D, Lorenz D, Isemer FE, Braun S, Fisseler-Eckhoff A. [Acetone treatment of lymph node preparations in staging colorectal specimens]. DER PATHOLOGE 2008; 28:269-72. [PMID: 17393170 DOI: 10.1007/s00292-007-0905-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lymph node staging is the most important prognostic factor after radical surgery for colorectal carcinoma. The probability of correctly classifying a colorectal tumor increases with the number of lymph nodes harvested. This number varies with the methods used by the pathologist. An accurate examination of the surgical specimens is essential for the correct assessment of the lymph node status of the tumor. The purpose of this study was to evaluate an easy fat clearance method using pure acetone. A total of 188 surgical specimens of colorectal carcinoma were investigated. The first lymph node preparation was made using the manual method. Thereafter, the mesenteric fat tissue was treated with pure acetone for 16 h and subjected to a second lymph node examination. In 111 of the samples the required number of 12 lymph nodes for TNM classification was not reached by the manual preparation method. With the acetone treatment, 12 or more lymph nodes were found 91% of these samples (average 27 lymph nodes). In 29 samples (15%) additional lymph node metastases could be detected. In 16 samples (8% of all investigated samples) an upstaging of the pN status was necessary. This indicates the importance of our method for the optimal lymph node staging of colorectal carcinomas. Lymph node preparation after acetone treatment is an easy, low cost method resulting in a much larger number of lymph nodes for more accurate staging.
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Abstract
PURPOSE OF REVIEW This review focuses on recent findings on the aetiological, clinical, pathological and genetic heterogeneity of essential tremor and new therapeutic approaches. RECENT FINDINGS Although essential tremor is one of the most common movement disorders, understanding of the causes and mechanisms of the disease is still very limited. Studies on the clinical presentation of essential tremor have expanded the clinical dimension, now including nontremor manifestations such as cerebellar signs, neuropsychological characteristics, distinct personality traits and behavioural symptoms. Results of neuropathologic and imaging studies are conflicting, with hints of neurodegeneration or a nondegenerative disturbance of functional circuits or receptors. Genetic heterogeneity of essential tremor has been demonstrated by linkage to three different chromosomal loci so far, and several negative genetic studies. New animal models are reinforcing previous hypotheses about gamma-aminobutyrate (GABA)-ergic mechanisms in essential tremor. New therapeutic agents for essential tremor have been tested and demonstrated to be partly effective. SUMMARY The traditional view of essential tremor as a single disease entity has been replaced with the concept that this disorder is a complex and heterogeneous disease. Heterogeneity of the condition, and lack of diagnostic criteria and objective diagnostic tests add to this problem. Many conflicting results may be due to differences in patient selection.
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Harter P, Gnauert K, Buhrmann C, Lehmann TG, Pohland D, Hils R, Kommoss S, Traut A, Lorenz D, du Bois A. Ergebnisse der operativen Therapie bei Erstdiagnose eines Ovarialkarzinoms in einem gynäkologisch-onkologischen Zentrum, HSK Wiesbaden. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-984652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lorenz D, Gäbel W, Redtenbacher M, Weissenhofer W, Minzlaff M, Stengel D. Randomized clinical trial comparing bipolar coagulating and standard great saphenous stripping for symptomatic varicose veins. Br J Surg 2007; 94:434-40. [PMID: 17385181 DOI: 10.1002/bjs.5727] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background
Typical side-effects of saphenous stripping for symptomatic varicose veins include painful thigh haematomas, which a new bipolar coagulating electric vein stripper (EVS) may reduce.
Methods
In a randomized, single-blind trial at three vascular centres, 99 patients were assigned to EVS and 101 to conventional stripping. The primary outcome was postoperative pain at rest and following physical exercise (climbing stairs). Haematomas were quantified by ultrasonography. Further endpoints were duration of postoperative compression, sick leave and quality of life (measured by the Chronic Lower Limb Venous Insufficiency Questionnaire (CIVIQ) and Short Form 36 (SF-36®)).
Results
Mean resting visual analogue scale for pain 24 h after surgery was 1·6 in the EVS group and 3·3 in the conventional stripping group (mean difference 1·7, 95 per cent confidence interval (c.i.) 1·4 to 1·9, P < 0·001). Mean ratings following exercise were 3·3 and 5·5 (mean difference 2·3, 95 per cent c.i. 2·0 to 2·6, P < 0·001) respectively. No patient in the EVS group had a measurable thigh haematoma, compared with 74 patients after conventional stripping (P < 0·001). The EVS significantly decreased the length of compression therapy and sick leave, and produced superior CIVIQ and SF-36 ratings.
Conclusion
The EVS was safe and effective in avoiding painful haematomas following varicose vein surgery.
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Lorenz D. Gesetzliche Anforderungen und Umsetzung. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Knudsen K, Lorenz D, Deuschl G. The pharmacokinetics of alcohol for essential tremor. AKTUELLE NEUROLOGIE 2007. [DOI: 10.1055/s-2007-987748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Witt K, Daniels C, Herzog J, Lorenz D, Volkmann J, Reiff J, Mehdorn M, Deuschl G, Krack P. Differential effects of L-dopa and subthalamic stimulation on depressive symptoms and hedonic tone in Parkinson's disease. J Neuropsychiatry Clin Neurosci 2006; 18:397-401. [PMID: 16963590 DOI: 10.1176/jnp.2006.18.3.397] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Patients with Parkinson's disease frequently have mild to moderate depression and exhibit low hedonic tone. The authors investigate the impact of a single L-dopa challenge and the acute effects of electric stimulation of the subthalamic nucleus (STN) on symptoms of depression and hedonic tone. Depressive symptoms improved with L-dopa and STN stimulation to the same extent. However, hedonic tone improved only with L-dopa. Most of the emotional changes did not correlate with changes in motor performance, indicating they were not just reactive but specific to the treatment. These results demonstrate a single dissociation of depressive symptoms and anhedonia in response to an acute L-dopa and STN-stimulation challenge.
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Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schäfer H, Bötzel K, Daniels C, Deutschländer A, Dillmann U, Eisner W, Gruber D, Hamel W, Herzog J, Hilker R, Klebe S, Kloss M, Koy J, Krause M, Kupsch A, Lorenz D, Lorenzl S, Mehdorn HM, Moringlane JR, Oertel W, Pinsker MO, Reichmann H, Reuss A, Schneider GH, Schnitzler A, Steude U, Sturm V, Timmermann L, Tronnier V, Trottenberg T, Wojtecki L, Wolf E, Poewe W, Voges J. A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med 2006; 355:896-908. [PMID: 16943402 DOI: 10.1056/nejmoa060281] [Citation(s) in RCA: 1843] [Impact Index Per Article: 102.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neurostimulation of the subthalamic nucleus reduces levodopa-related motor complications in advanced Parkinson's disease. We compared this treatment plus medication with medical management. METHODS In this randomized-pairs trial, we enrolled 156 patients with advanced Parkinson's disease and severe motor symptoms. The primary end points were the changes from baseline to six months in the quality of life, as assessed by the Parkinson's Disease Questionnaire (PDQ-39), and the severity of symptoms without medication, according to the Unified Parkinson's Disease Rating Scale, part III (UPDRS-III). RESULTS Pairwise comparisons showed that neurostimulation, as compared with medication alone, caused greater improvements from baseline to six months in the PDQ-39 (50 of 78 pairs, P=0.02) and the UPDRS-III (55 of 78, P<0.001), with mean improvements of 9.5 and 19.6 points, respectively. Neurostimulation resulted in improvements of 24 to 38 percent in the PDQ-39 subscales for mobility, activities of daily living, emotional well-being, stigma, and bodily discomfort. Serious adverse events were more common with neurostimulation than with medication alone (13 percent vs. 4 percent, P<0.04) and included a fatal intracerebral hemorrhage. The overall frequency of adverse events was higher in the medication group (64 percent vs. 50 percent, P=0.08). CONCLUSIONS In this six-month study of patients under 75 years of age with severe motor complications of Parkinson's disease, neurostimulation of the subthalamic nucleus was more effective than medical management alone. (ClinicalTrials.gov number, NCT00196911 [ClinicalTrials.gov].).
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Lorenz D, Hagen K, Ufer M, Cascorbi I, Deuschl G, Volkmann J. No benefit of 3,4-diaminopyridine in essential tremor: a placebo-controlled crossover study. Neurology 2006; 66:1753-5. [PMID: 16769957 DOI: 10.1212/01.wnl.0000218297.90054.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
3,4-Diaminopyridine (3,4-DAP) is a potassium channel blocker that has recently demonstrated an antioscillatory effect in humans by significantly reducing downbeat nystagmus. Based on the presumed role of intrinsic oscillations in the pathophysiology of essential tremor (ET), the authors conducted a double-blind, placebo-controlled crossover study assessing the antitremor effect of a single dose of 3,4-DAP in 19 patients with ET. They did not find any significant change in tremor severity as measured by clinical ratings or accelerometry.
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Gockel HR, Heidemann J, Lorenz D, Gockel I. Spontaneous splenic rupture, in tertian malaria. Infection 2006; 34:43-5. [PMID: 16501903 DOI: 10.1007/s15010-006-4126-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Accepted: 03/16/2005] [Indexed: 11/24/2022]
Abstract
We report a case of tertian malaria in a 36-year-old Caucasian male complicated by spontaneous splenic rupture 2 months after returning from Kenya. The ruptured and enlarged spleen displaying multiple subcapsular hemorrhages was surgically resected. Histological examination revealed a marked enlargement of the red pulp and a reduced white pulp in addition to hyperemia of the spleen. Tertian malaria was diagnosed by peripheral blood smear and elevated antibody titer against Plasmodium vivax. The patient underwent antimalarial therapy with chloroquine and primaquine and the further course was uneventful. Etiopathology, differential diagnosis and therapy of this rare complication in malaria are discussed.
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Renaud S, Fuhr P, Gregor M, Schweikert K, Lorenz D, Daniels C, Deuschl G, Gratwohl A, Steck AJ. High-dose rituximab and anti-MAG-associated polyneuropathy. Neurology 2006; 66:742-4. [PMID: 16534115 DOI: 10.1212/01.wnl.0000201193.00382.b3] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Rituximab has been administered successfully in patients with polyneuropathy associated with antibodies to myelin-associated glycoprotein (anti-MAG). The authors present a follow-up study with high-dose rituximab. Increase of rituximab from 375 mg/m2 to a dose of 750 mg/m2 was well tolerated and led to clinical improvement in four of eight patients, along with improvement of nerve conduction velocities and a reduction of anti-MAG antibody titers.
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Lorenz D, Schwieger D, Moises H, Deuschl G. Quality of life and personality in essential tremor patients. Mov Disord 2006; 21:1114-8. [PMID: 16622851 DOI: 10.1002/mds.20884] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to determine the impact of essential tremor (ET) on quality of life and its relation with tremor severity and the personality profile of ET patients. One hundred and five patients with definite or probable ET from an outpatient population were tested with the Short-Form 36-Item Health Survey (SF36) and the Eysenck Personality Questionnaire (EPQ-R). Compared to controls, the ET patients scored worse in all eight domains of the SF36. The physical component score (PCS) did not differ significantly from the normal population, whereas ET patients older than 40 years were significantly more affected with regard to the mental domains measured by the mental component score (MCS) with their median below the 20th percentile of the German controls. Tremor severity correlated with some of the physical domains and the PCS as well as with social function of the mental domains. ET patients showed significantly lower scores in the psychoticism (P) scale of the EPQ-R, with a median value on the 11th percentile of normal German population, indicating a more tender-minded personality type. The MCS correlated highly significant with the neuroticism (N) scale and extraversion (E) scale of EPQ-R. Multiple regression analysis identified age as the only predictive factor for the PCS and the N-scale as the only predictive factor for the MCS. Although ET is considered a pure movement disorder, the mental components of quality of life are more affected than the physical dimensions. A more controlled personality type may in part contribute to this.
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Lorenz D, Sust CA. Bildschirmarbeitsplätze in radiologischen und nuklearmedizinischen Abteilungen – Ergebnisse einer empirischen Erhebung. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Klebe S, Stolze H, Kopper F, Lorenz D, Wenzelburger R, Deuschl G, Volkmann J. Objective assessment of gait after intrathecal baclofen in hereditary spastic paraplegia. J Neurol 2005; 252:991-3. [PMID: 15765194 DOI: 10.1007/s00415-005-0792-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2004] [Revised: 12/01/2004] [Accepted: 12/02/2004] [Indexed: 12/01/2022]
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Lorenz D, Kullich W, Redtenbacher M, Weissenhofer W. Bloodless removal of varicose veins - a new technique. Phlebology 2004. [DOI: 10.1258/0268355042554975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To describe the use of a novel electric vein stripper (EVS) for use in patients with varicosities of the greater saphenous vein and tributaries. Methods: In addition to standard procedures as performed in varicose veins of the lower limb, an EVS, powered by a standard high frequency electrocoagulation generator (HF), is introduced. The application of this new EVS makes it possible to avoid tearing of the structures of the subcutaneous tissue surrounding the greater saphenous vein, leaving the channel of the vein blood dry. Results: A preliminary study including two groups of patients - 20 in the Babcock group and 24 in the EVS group - resulted in significantly reduced pain and discomfort. An added benefit for the patients was the fact that postoperative compression bandages were not needed. Conclusions: Application of EVS can prevent bruising and haematomas in vein stripping can be avoided.
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Drefahl G, Lorenz D. Polymerisationsfähige und polymere Verbindungen. II. Styrolverbindungen von Zinn, Blei und Quecksilber. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/prac.19640240110] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Drefahl G, Lorenz D. Polymerisationsfähige und polymere Verbindungen. III. Notiz zur Darstellung des Tetra-p-vinylphenyl-silans. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/prac.19640240506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Klebe S, Stolze H, Kopper F, Lorenz D, Wenzelburger R, Volkmann J, Porschke H, Deuschl G. Gait analysis of sporadic and hereditary spastic paraplegia. J Neurol 2004; 251:571-8. [PMID: 15164190 DOI: 10.1007/s00415-004-0366-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2003] [Revised: 11/21/2003] [Accepted: 11/26/2003] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Sporadic (SSP) and hereditary spastic paraplegias (HSP) are clinically and genetically heterogeneous disorders, which are characterised by a slowly progressive spastic paraparesis. Initial symptoms and the rate of progression are variable even among members of the same family. Spastic paraparesis is the major and most disabling clinical symptom and was assessed with gait analysis using a three-dimensional infrared movement analysis system. METHODS AND RESULTS 22 patients with clinically and/or genetically confirmed SSP/HSP were compared with age-matched control subjects. Significantly lower values were found for gait velocity, stride length, step height and the range of motion of the knee-angle. The gait pattern is characterised by a severe spasticity of both legs with only mild paresis. The balance-related gait parameters show a broad-based gait without inwardly rotated feet. No correlation was found between disease duration and the severity of the gait disorder and the central motor conduction time to the leg muscles and the abnormal gait parameters. The gait pattern did not differ between the 7 SSP cases and the 15 HSP cases. CONCLUSIONS We conclude that three-dimensional gait analysis can uncover specific features of such rare gait disorders, and may be used as an objective tool to quantify the impairment of gait parameters in patients with SSP/HSP and thus can be used to monitor disease progression and the effect of therapeutic interventions.
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